Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the symptoms of interstitial lung disease?
Decreased lung function is the result of the inflammation present in the
supporting interstitial tissues, which leads to scarring and thickening. This is
because the thickened and stiff tissues cannot breathe as effectively as healthy
lung tissue. Symptoms, therefore, are related to the reduced efficiency of
breathing and corresponding reduced levels of oxygen in the blood.
The symptoms depend to a certain extent upon the exact
cause of the condition, but shortness of breath and a dry cough are the most common symptoms.
In most cases, these symptoms develop gradually. Signs of chronically reduced
oxygen levels in the blood include clubbing (a painless enlargement of the
fingertips) and an enlarged heart.
Interstitial lung disease can lead to serious long-term complications.
Pulmonary hypertension,
a type of high blood pressure that affects the arteries within the lungs, may
develop. Ultimately, right-sided (the side of the heart that pumps blood back to
the lungs to receive oxygen) heart failure may result (known as cor pulmonale). Respiratory failure is a potentially fatal long-term
complication of interstitial lung disease.
How is interstitial lung disease diagnosed?
Interstitial lung disease cannot be diagnosed simply on the basis of a
medical history and physical examination. In most cases, a number of diagnostic
tests must be used. The symptoms of interstitial lung disease overlap with those
of many other conditions, including cardiovascular diseases.
Imaging studies, such as chest X-rays and
CT scans are often the first
diagnostic step and may also help rule out other conditions that may cause
similar symptoms.
Pulmonary function tests (PFTs) are noninvasive tests that measure the
function of the lungs. The test involves blowing into a tube that is part of an
instrument called a spirometer. This can measure the volume of the lungs as well
as the air flow into and out of the lungs.
Biopsies or washings may be taken of the lungs and
airways during bronchoscopy (examination of the airways with a viewing tube). The removed
tissue samples are then examined by a
pathologist to establish the diagnosis. In
certain cases, open surgical biopsy of the lung may be required to obtain an
adequate tissue sample for diagnosis.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Pulmonary fibrosis is scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic inflammatory processes, infections, environmental agents, exposure to ionizing radiation, chronic conditions, and certain medications. Symptoms include shortness of breath, coughing, and diminished exercise tolerance. Treatment options are dependent on the type of pulmonary fibrosis; lung transplant and/or medications are optons.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Asbestos exposure lung disease is divided into three main types, asbestosis (lung scarring caused by asbestos fibers), disease of the lining of the lung (pleural plaques, scarring, or fluid accumulation), and lung cancer. Mesothelioma is cancer of the lining of the lung caused by asbestos exposure. Cancers of the larynx, throat, kidney, esophagus, and gallbladder have been linked to asbestos exposure. Treatment is dependant upon the type of condition related to asbestos exposure.
Hypersensitivity Pneumonitis is an inflammation of the lung caused by small airborne particles such as bacteria, mold, fungi, or inorganic matter. There are two types of hypersensitivity pneumonitis, acute and chronic. Symptoms include fever, chills, cough, shortness of breath, body aches. Examples of hypersensitivity pneumonitis include bagassosis, mushroom worker's disease, sauna taker's disease, pigeon breeder's disease, and farmer's lung disease. Most commonly, it results from exposure to pet birds.
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